A second, which was favored for some time by FEMA, would take advantage of the lead time afforded by the observed movements to relocate 145 million of our own citizens. to launch a first strike directed at the highly vulnerable evacuees. One response to this message, albeit an unlikely one, would be for the U.S. intelligence sources interpreted as a warning of an impending nuclear strike.
Such large-scale population movements would be readily detected by U.S. It is estimated that it would take from 3 to 5 days to complete the process. The Federal Emergency Management Agency ( FEMA) assumes that the Soviet Union would not launch a preemptive strike without first protecting its own citizens (or at least reducing the number of anticipated casualties to tolerable levels), by evacuating the larger cities and population centers proximate to major industrial plants. The Central Intelligence Agency (CIA) notes that there is sufficient blast-resistant shelter space for the Soviet leadership at all levels (Weinstein, 1981). It is well known that the Soviet Union has invested considerable effort to develop an effective civil defense system. Under ideal circumstances it might reduce casualties, but if thought to be too effective it could also destabilize the arms race, and under certain conditions heighten the potential for misinterpreting intentions. Accordingly civil defense could play a dual role. If one subscribes to MAD, then it must follow that any movement to reduce vulnerability or enhance offensive capacity heightens the risk of war. Deterrence is thought by some to be stable so long as populations and industry remain vulnerable to the destructive capacity of the other side. Mutual assured destruction (MAD) is founded on the condition that each side's offensive weaponry surpasses the defensive capability of the other. We view this as an opportunity to question, speculate, and entertain possibilities that may not have been previously considered. However, we do not apologize for raising a wide variety of issues that may frustrate even the most patient reader. In such a short paper, we cannot pretend to cover the subject of socioeconomic consequences in any depth. As a result, published projections that implicitly adopt current economic and social arrangements should be questioned as well. There is, on the other hand, no shortage of assumptions regarding the nation's institutions, individual behavior, and the likelihood of social change, none of which have been seriously questioned. To our knowledge, little has been done on such subjects as social response to a warning of nuclear attack willingness of health care organizations to administer aid under postattack conditions ability of a moneyless economy to rebuild without the aid of other nations and without a heavy reliance on fuel oils.
Much of the work was performed in the mid-1960s to mid-1970s and is therefore dated. The citations that were uncovered appeared to be confined almost entirely to the application of economic theory to problems of reconstruction. However, a review of the literature on the consequences of nuclear war revealed few references to social science research. As work progressed, it became increasingly apparent that research into the direct and immediate impact of war has been, and continues to be, the subject of considerable effort. The original purpose of this paper was to assess the systemic effects of a limited nuclear war and offer some thoughts regarding the potential health care complications that might result.
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